L.v. Officials Say Gap In Law May Permit Hospital To Use New Scanner

A $1.4-million magnetic scanner came to Allentown in May without a review of its need or cost because it was to be used for outpatients, and was purchased by a private company rather than a hospital.

But now NMR of America, the Morristown, N.J.-based owner of the equipment, is seeking state review to use the sophisticated diagnostic equipment on hospital patients as well. It's a plan some area officials fear will be repeated, causing excess equipment, costs and use in the community.

NMR of America did send the state Department of Health notice of its intent to expand services to inpatients, but has yet to file a formal application. It operates a magnetic resonance imaging (MRI) scanner for outpatients on the first floor of 451 Medical Plaza, a new medical office building attached to Sacred Heart Hospital and owned by Sacred Heart physicians.

State officials said the new inpatient service would require a review.

However, Peter Archey, executive director of the Health Systems Council of Eastern Pennsylvania (HSC), wonders how the state can turn down the for-profit company, now that the equipment is in place and there would be no additional cost.

"The dilemma is this: How does one tell (patients) they have to get in an ambulance, bypass equipment that is here, and travel 35 to 40 miles away for a scanner approved for inpatient use," he said. The next-nearest magnetic scanner approved for hospital patients is in Reading.

Archey said the circumstances represented "an enormous gap in the law.

"When this equipment is reviewable in a hospital and not generally elsewhere, you have a contradiction in law . . . This type of equipment purchase should be reviewable regardless of the setting . . . or not be reviewable at all," he said yesterday.

Charles MacKay, president of the Lehigh Valley Business Conference on Health Care, added, "It's difficult for me to believe the parties involved did not anticipate the use of the equipment for diagnosing inpatients when it was installed.

"It is my understanding that the project was initially non-reviewable only because it did not represent a new in-patient service or hospital purchase. It is perfectly legal to escape review by the sort of procedure that appears to have been followed here, and it is foolish to ask parties who see financial and professional gain to go beyond the letter of the law. Still, it's unfortunate that the negative impact of excess equipment is once again apparently beyond the understanding of the provider community," MacKay said.

Efforts to reach representatives of NMR of America or Sacred Heart Hospital officials for comments yesterday were unsuccessful.

MRI used a powerful magnet to take multi-dimensional images, without harmful radiation, to detect diseases and abnormalities. It is said to produce superior images of the head, neck, spine and skeletal joints.

A limited partnership of Lehigh Valley Hospital Center physicians also received approval from the state last year to purchase an MRI for outpatient use. Currently on order, the equipment is expected to be operational in early 1987 and principals indicate they too will consider in-patient use.

Lewis Wolkoff of the state health department's division of need review, said the state would consider a recommendation from the regional HSC and could turn it down.